STATE BUDGET CONFERENCE COMMITTEE PLAN

TO RAIDCOUNTY MADDY FUNDS

TALKING POINTS

Maddy Funds have been available to counties to support emergency medical services systems, including funds to pay emergency department physicians and hospitalsfor emergency medical care provided to patients who have no payer source nor funds to pay for care.

The Emergency Medical Administrators Association of California (EMSAAC) which represents all counties in California, strongly opposes the State Budget Conference Committee’s plan to take these essential funds from counties. The Committee’s action was taken without any advance notice nor opportunity toprovide input and clearly demonstrates a fundamental lack of understanding of the importance of retaining the Maddy Funds to continue to operate emergency medical services systems. The elimination of this funding will devastate a county’s ability to provide emergency medical service programs to all those who call 911, insured and uninsured alike. In emergency medical services, there is no differentiation in service based upon payer or lack of payer. The plan to move these funds to the State in order to obtain a Medi-CAL match provides nothing to address the burden of counties charged with developing, implementing, monitoring, evaluating and providing medical oversight to emergency medical services systems of care. In fact, the action will devastate emergency medical services programs designed to ensure equal access to high quality, well supervised emergency medical care.

This raid of Maddy Funds will also add yet another unfair burden on the healthcare safety net providers, at a time when both MediCare and Medi-CAL are proposing to again reduce rates for reimbursement.

This continuous loss of reimbursement to the Emergency Healthcare Community is unsustainable, and will lead to the loss of life, unnecessary suffering and a catastrophic failure of this critical service.

Examples of EMS functions that will be severely limited or eliminated include the following:

  • Oversight and coordination of public and private sector paramedics and EMTs
  • Physician oversight for clinical practice by paramedics and EMTs, public and private sectors
  • Implementation, coordination, and medical oversight of specialty care EMS programs, such cardiac hospitals, stroke hospitals, trauma adult and pediatric hospitals
  • Elimination and/or significant curtailment of paramedic and EMT services in rural areas where Maddy Funds are used to train,supply medications and medical equipment for volunteer fire department EMS responders
  • Disaster medical response and multi-casualty incident coordination among paramedics, EMTs and hospitals, regional, state and federal resources
  • Certification and discipline of EMTs, including collection of State required fees for EMT certification
  • Accreditation of all paramedics, public and private, to ensure knowledge and competency in local EMS programs
  • Authorization and coordination of all hospitals that receive 911 patients
  • Coordination of countywide EMS communications
  • Licensing and inspections of ambulances

Examples of impact of eliminating emergency physician funding:

  • Inability to maintain emergency department physician call panels
  • Prolonged emergency department wait times
  • Prolonged ambulance turn-around times in emergency departments, often referred to as “bed delay” or “wall time”
  • Resultant delayed ambulance responses to incoming 911 calls due to long patient turn-around times in emergency departments

A local EMS agency is required by the Health & Safety Code for each county to authorize paramedic services. Many local EMS agencies depend upon Maddy Funds to maintain services and physician oversight for an EMS system. Loss of the funds may result in some counties eliminating their EMS agency and reverting to a lower level of medical care for 911 responses.

3/11/11